Effect of autograph used in anterior cruciate ligament reconstruction surgery on postoperative infection rate

Abstract

Purpose: The aim of this study was to investigate effectof autograft selection on the infection risk followingarthroscopic anterior cruciate ligament (ACL)reconstruction surgery.Materials and Methods: Between June 2004 andOctober 2018, 840 consecutive patients who underwentprimary arthroscopic ACL reconstruction with either ahamstring tendon autograft or a bone patellar tendon bone(BTB) autograft were reviewed retrospectively. Patientswere assigned into two groups based on the type of graftused: First group was bone-patellar tendon-bone (BTB)autograft group (n=354) and second group was hamstringtendon autograft group (n=466). These two groups werecompared statistically in terms of demographiccharacteristic and postoperative infection status. Afterprimary ACL reconstruction, local and systemic clinicalfindings of infection (knee effusion, systemic fever,nausea, weakness) supported by laboratory findings (CReactive Protein (CRP), Erytrocyt Sedimentation Rate(ESR)) were defined as infection.Results: There was a statistically increased risk ofinfection with hamstring tendon autograft compared toBTB autograft. While the infection rate in the first group(BTB) was 0.3 % (n=1), the infection rate in the secondgroup (Hamstring tendon) was 4.7 % (n=22).Conclusion: In this study, a higher infection rate wasfound in primary ACL cases treated with hamstring tendonautograft compared to those using BTB autografts.Orthopedic surgeons should be aware of the increased riskof infection when hamstring autograft is used in ACLreconstruction surgery and should prefer BTB autograftover hamstring autograft in appropriate indication.